| NPI | 1689686701 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MI 4301059568) |
| Additional Taxonomies | 261QU0200X Clinic/Center, Urgent Care (Licence: TN 63503) |
| Enumeration Date | 2006-08-13 |
| Last Update Date | 2026-05-04 |